U.N. Seeks to Curb Role in Spread of AIDS

U.N. peacekeepers are supposed to bring stability to countries in conflict. But now the world organization is grudgingly admitting an unsettling secret: In addition to aid, the troops provide a network for the transmission of AIDS.

“I regret to say that AIDS is being spread, among other people, by peacekeepers,” said U.S. Ambassador Richard Holbrooke, who, as this month’s president of the Security Council, has declared January the “Month of Africa,” with a focus on the disease. “AIDS is being spread by the sex trade and truck routes, that’s true. But it is also being spread by military and police forces.”

It’s not something the U.N. likes to talk about. And Holbrooke’s comments Wednesday broke ground here about the unwitting role the U.N. community plays in the transmission of a disease that the world body spends millions each year to combat.

But the dangerous liaisons between international workers and locals are all too common knowledge to people who live and work in the countries in which platoons of peacekeepers alight.

“People in uniform are just magnets for the sex worker crowd everywhere, not only at home military installations, but even more so in low-income countries when peacekeeping operations arrive,” said Stuart Kingma, the director of a U.N.-backed group to combat military transmission of HIV, the virus that causes AIDS.

Testing of U.N. soldiers from North America, Europe and Asia after their mission to Cambodia in 1993 found that some were carrying an HIV strain unique to Southeast Asia and believed then to be more potent than others. Finnish soldiers returned home infected after a tour of duty in Namibia in the early 1990s.

There have been few scientific studies of how widespread the problem has become since then, and publicly documented cases from each peacekeeping mission range in the handfuls, not hundreds. But legitimate fears that the peacekeepers not only bring new strains home from foreign assignments but also introduce them to the countries where they are deployed led to calls by some member states for mandatory testing of all U.N. peacekeepers.

The move was rejected by the U.N. General Assembly in 1991 because some countries lacked the equipment and training for proper screening and counseling. The U.N. also cited privacy and discrimination issues--the social stigma of being HIV-positive can ruin careers and break apart families, especially in Africa. But because 10 times as many people have died in the past 10 years of AIDS in Africa as have been killed in war during the same period, the issue remains important.

“It’s still a lively debate,” Kingma said. “I am sure the issue will come up again.”

Worries persist that the hastily assembled multinational force in newly autonomous East Timor may not have had time for a good education on the problem and that peacekeeping troops in Africa are going from one high-risk environment to another.

“These are young people away from their country, under stress, who want recreation,” said a medical services worker who has visited missions in nine African countries in the last several years to talk about AIDS prevention. Inevitably, sex workers are drawn to the camps to provide services. “We can’t stop that. We can try to educate [the peacekeepers].”

Breaking through the stigma of AIDS is the United Nations’ aim for Africa, which has the highest rate of AIDS deaths in the world. The U.N.-sponsored Civil-Military Alliance to Combat HIV and AIDS will start training programs this year in six African countries. Their tools are boxfuls of condoms and blue booklets with graphic advice about protection.

“It’s a very difficult problem because the peacekeepers are composed of so many cultures,” said a doctor from the U.N. peacekeepers’ medical team. But during a recent trip to Congo, a soldier came up and asked her, “Where are the condoms?” a question that she says would never have been posed so openly to a woman just a few years before.

“To me,” she said, “that was a very positive change.”